BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

Chapter XV
Medical Attention
Medical attention rendered during pregnancy
and delivery to mothers of deceased
children, as well as that received by the
children, can be studied from data collected
in the interviews of families during the
course of the Investigation. In many instances
data obtained from hospitals and
other sources complemented that information.
In this report reference will be made
to services provided and to several parameters
pertaining to deceased children and
their mothers in the hope that this information
will serve as a basis for action to solve
the problems uncovered.
PRENATAL CARE
Prenatal care, as defined by Willson et al.
(1971), is a program of examination, evaluation,
observation, treatment, and education
of pregnant women, directed toward making
pregnancy, labor, and delivery as normal
and safe as possible for mothers and their
infants.
Even before pregnancy, high reproductive
risk can be recognized by making use of
various measures such as mother's age,
parity, general state of health, and stature,
the history in regard to health and survival
of previous products, family's socioeconomic
conditions, and others. A scoring system
such as that suggested by Perkin (1968)
could help to establish norms that might
be utilized as a basis for preventing vital
wastage and serious maternal and infant
morbidity.
Once gestation has begun, surveillance
during the first trimester is essential in
order to assess the general health of the
mother and detect specific disorders such as
anemia, infection, cardiac or renal diseases,
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and endocrine conditions. Nutrition and
health education should be started at this
time (if it has not before) and prevention
of teratogenic factors should be stressed.
A program for the remainder of pregnancy
and for childbirth should be outlined according
to the level of risk established.
The success achieved in collecting inforination
on prenatal care varied among the
projects, depending on the possibility of
conducting family interviews and on the
quality of clinical records.
The data on prenatal care for mothers
of deceased infants are presented in Table
174, according to the stage of pregnancy in
which the cere was first received. Figure
148 shows the percentages of mothers who
attended a prenatal service at any time